Provider Demographics
NPI:1801505730
Name:PMD WELLNESS CENTER INC
Entity type:Organization
Organization Name:PMD WELLNESS CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ISAIAS
Authorized Official - Middle Name:
Authorized Official - Last Name:PAJA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-599-2119
Mailing Address - Street 1:780 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90813-4565
Mailing Address - Country:US
Mailing Address - Phone:562-624-1111
Mailing Address - Fax:562-624-1114
Practice Address - Street 1:780 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90813-4565
Practice Address - Country:US
Practice Address - Phone:562-624-1111
Practice Address - Fax:562-624-1114
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PMD WELLNESS CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-11-18
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty